Quid Pro Quo? A Critical Perspective on the Global Flow and Spread of Health Innovation

Document Type : Editorial

Authors

1 Health Services Management Centre, University of Birmingham, Birmingham, UK

2 School of Health and Social Care, University of Essex, Colchester, UK

Abstract

Over recent decades, the exchange of health innovations between high-income countries (HICs) and low- and middle-income countries (LMICs) has grown significantly. Three main types of cross-border flows characterise this global health innovation ecosystem: (i) trickle-down innovation – where innovations originating in HICs gradually diffuse to LMICs, (ii) reverse innovation, where new solutions originating in LMICs are adopted and adapted in HICs, and (iii) reciprocal innovation – where the focus is on bidirectional exchange and learning between HICs and LMICs. Despite embracing multidirectional flows, the contemporary global health innovation ecosystem is fundamentally shaped by neocolonial power imbalances that prevent LMICs from fully benefiting. These dynamics are further intensified by recent cuts to foreign aid and the rise of philanthrocapitalism, both of which concentrate power and influence in HICs. Viewing health innovation through a neocolonial lens reveals how the current innovation ecosystem reinforces historical patterns of dependency and domination in global health.

Highlights

Russell Mannion (Google Scholar) (PubMed)

Keywords

References

  1. Hussain M, Sadigh M, Sadigh M, et al. Colonization and decolonization of global health: which way forward? Glob Health Action. 2023;16(1):2186575. doi:1080/16549716.2023.2186575
  2. Victora CG, Bahl R, Barros AJD, et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016; 387(10017):475-490. doi:1016/S0140-6736(15)01024-7
  3. Yazdi-Feyzabadi V, Haghdoost A, McKee M, et al. The United States withdrawal from the World Health Organization: implications and challenges. Int J Health Policy Manag. 2025. doi:34172/ijhpm.2025.1234
  4. Mediavilla J, Garcia-Arias J. Philanthrocapitalism as a neoliberal (development agenda) artefact: philanthropic discourse and hegemony in (financing for) international development. Globalizations. 2019;16(6):857-875. doi:1080/14747731.2019.1567977
  5. Koot S, Fletcher R. Popular philanthrocapitalism? The potential and pitfalls of online empowerment in “free” Nature 2.0 initiatives. Environ Commun. 2020;14(3):287-299. doi:1080/17524032.2019.1687099
  6. Stevenson M, Youde J. Public-private partnering as a modus operandi: explaining the Gates Foundation’s approach to global health governance. Glob Public Health. 2021;16(3):401-414. doi:1080/17441692.2020.1822897
  7. Ishimwe M, Kiplagat J, Knowlton AR. Reversing the trend: a scoping review of health innovation transfer or exchange from low- and middle-income countries to high-income countries. BMJ Glob Health. 2023;8(Suppl 7):e012332. doi:1136/bmjgh-2023-012332
  8. Syed SB, Dadwal V, Rutter P, et al. Developed-developing country partnerships: benefits to developed countries? Global Health. 2012;8:17. doi:1186/1744-8603-8-17
  9. Quijano A. Coloniality of power, Eurocentrism, and Latin America. Nepantla Views South. 2000;1(3):533-580.
  10. Sors TG, O’Brien RC, Scanlon ML, et al. Reciprocal innovation: a new approach to equitable and mutually beneficial global health partnerships. Glob Public Health. 2023;18(1):2102202. doi:1080/17441692.2022.2102202
  11. Harris M, Weisberger E, Silver D, Dadwal V, Macinko J. That’s not how the learning works—the paradox of reverse innovation: a qualitative study. Global Health. 2016;12:36. doi:1186/s12992-016-0175-7
  12. Harris M, Dadwal V, Syed SB. Review of the reverse innovation series in globalization and health—where are we and what else is needed? Global Health. 2020;16(1):26. doi:10.1186/s12992-020-00555-8
  13. Dearing JW, Masquillier C, van Olmen J. Reciprocal coproduction as a basis for the diffusion of global health innovations. BMJ Glob Health. 2023;8(Suppl 7):e012235. doi:1136/bmjgh-2023-012235
  14. Basu L, Pronovost P, Molello N, et al. The role of South-North partnerships in promoting shared learning and knowledge transfer. Global Health. 2017;13:44. doi:1186/s12992-017-0269-8
  15. Koplan JP, Bond TC, Merson MH, et al. Towards a common definition of global health. Lancet. 2009;373(9679):1993-1995. doi:1016/S0140-6736(09)60332-9
  16. Pai M. Reciprocity in global health: here is how we can do better. Forbes. April 15, 2020. https://www.forbes.com/sites/madhukarpai/2020/04/15/reciprocity-in-global-health-here-is-how-we-can-do-better/.

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History

  • Received Date: 14 April 2025
  • Revised Date: 06 October 2025
  • Accepted Date: 08 October 2025
  • First Published Date: 18 October 2025
  • Published Date: 01 December 2025

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